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EDITORIAL COMMENT These are controversial and troubled times in the medical profession. With the advent of new technology making the unheard of possible, there are those who share the enthusiasm of future breakthroughs and those critical of moving too fast into unsure
waters. The abortion issue is no longer a subacute persisting ache but is now accelerating to the fore. The prolifers and the prochoicers have drawn a very black and white line on an issue that one can hardly call " all of nothing." Pregnancy is har-
OPINIONS AND REPLIES TO THE EDITOR: Specifications: - 60 stroke line - double spaced - type written
dly a disease as some proabortionists would have you believe. Yet it is not the enjoyable or wanted experience to a young girl or the rape victim. Abortion is an individual problem within a social framework, and only cool heads can hammer out a solution. Another disturbing event recently was the senseless destruction of important animal research by the radical A .L.F. There is nothing wrong for the layperson to question motives and actions of the medical profession, since we are supposed to be responsible to the general public. Violent means,
however, never justify an end. To perpetuate human suffering should be a criminal offence be it directly or indirectly! Since many humans have yet to receive those rights in this sometimes unjust world, to place an animal's rights before man is a petty philosophical exercise of those well-off, non-struggling animal rights activists with plenty of time on their hand to go and search for a misguided cause to justify their violent nature.
HAVE A NICE DAY! CO-EDITORS: R.A. Zimmer K. Elsworthy
CHRZAN
At Victoria HopSital, South Street. on Monday, Februorv 25. 1985. Doctor George Chrzan. M.D.• in his 75th year. Beloved husband of Marie (Schmitz) Chrzan . Dear fa· I her of Mrs. Patrick (Betty) Henry of Markham. Janet Chrzan of Unionville, and Charles Chrzan of Toronto. Loving gro:1dfather of Jamie, Robbie, Jennifer. and Andrew. To the family of the man, my family doctor for most of my life, who first got me interested in Medicine, and who encouraged me to pursue that goal, I give you my condolences. I can only hope to be as good and as kind as he was.
Opinions: - 1500 word limit Replies: - 500 word limit Any letters failing to meet these requirements wilJ not be published in the Opinion File. Send c/ o Faculty of Medicine.
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CLASS NEWS MEDS'87 CLASS NEWS by Rob Sales (Class President) We were cautiously warned that second year would be a " heavy" year, but things seem to be getting a little ridiculous. A course committee chairman (Not I. C. C.) suggested that, due to the recent L.M.C.C. results, our final would be a little more " challenging." Well, we are being challenged to the hilt and attempting to survive endless hours in UH B, and digesting copious amounts of informa-
tion. Is this all needed to do the future "SCUT' work in Clerkship? In spite of time restraints, Meds '87 has been very active in extracurricular activities. Most notably was the phenomenal participation in Tachy '85. Meds '87's efforts created " My Gun Is Hard" and "Clerking With Myself'. Let's hope everyone had the satisfaction of " a job well done! " Look out for next year when tradition may just be broken, Best Show
... Meds'87???
years.
The executive of Meds '87 has resorted to surveys to try and get class input into issues such as mandatory small group attendance, reasons for poor attendance, suggestions for Tachy '86, and many other concerns. This exercise proved to very useful and informative with 80 surveys being filled out Hopefully, surveys will be a source of student input by Meds '87 and possibly other
Our time in " UH B" is nearing and end We hope that the many, many lecturers we have had this year can appreciate that we may not recognize their material or even recall that they lectured us! It's all a Blue Haze of Slides now. We really do appreciate the efforts of the F acuity, especially Dr. Edmunds, I.C.C . course co-ordinator. Thanks for breaking up the fmal exam.
ADMISSIONS NEWS ADMISSIONS NEWS Compiled by Robert Turliuk, Meds'87 For the benefit of students, faculty and future medical students, the following is a summary of data as related to the admissions of students in the class ofMeds '88 at the University of Western Ontario (U.W.O.). Figure 1. Profile of All Applicants to U.W .O . Medical School Class of '88. 1760 Ontario Residents 309 Other Residents Canadian Citizens
1945 111 13
Permanent Residents No Status Residents Total Applicants
2069
Male Applicants Female Applicants
1283 786
1 Year University 2 Years University 3 or 4 Years University 4 Years University
94 531 1156 286
Total Applicants
2069
Figure 2. Prior Education Profile for U.W.O . Medical School Class of ' 88: 1 and 2 yr. students 3 and 4 yr. students Graduate students Total Class Size
69 33 3
lOS
Figure 3. U.W.O. Medical School Admission Offers - Accepted/Declined for Class of '88: Offers to females Offers to males
41 93
Offers accepted females Offers accepted males
31 74
Offers to 1 and 2 yr. students Offers to 3 and 4 year students Offers to graduate students
88 41
5
Total Offers
134
Offers Declined Total Class Size
105
29
Figure 4 . Highest Degree Held Prior to Admission into Class of '88. No degree Baccalaureate degree Masters degree Doctorate degree Graduate degree
72 28
2 1 2
Additional Information Only 4 out of province offers were made. There were 30 out of province applicants on the waiting list; most accepted in their own province or were so far down the list that their name did not come up. The author would like to acknowledge Dr. J .H. Watson M.D. for providing data from the Faculty of Medicine.
Photos by R.A.Z.
Tachademy Awards- Rehab's offering.
Madam Superior and her backup dancers, the Bad Habits.
MC's John Ross and Heather MacDonald with friends.
Inwood and Squires, ' unscrupulous mentors.'
Urea Von Tramp's Band of Misfits. THE SOUND OF MUCUS (A School of Nursing Presentation)
deVeber and Cooper, "Dueling Damsels."
LUST EXCITING AND NEW ... by Lila Georgevich
The Lust Boat embarked on its maiden voyage on Monday, February II with a shipload of obstetricians, gynecologists, UWO faculty, students, and the various, assorted perverted crew. Meds merrymakers Bob Reddoch, Ed Kim and assistants were pregnant with theme ideas and the Lust Boat theme was conceived in the UH cafeteria in early October (when we were still allowed to eat there). After the first Tachy writing party, the writers were off and running, coming in just under the line with a fmished script before the "Great Histology Exam of Nov. '88." Two rehearsals for the main characters were held before Christmas. After Christmas, with the delivery date looming close, the props team lept into action, producing, among other backgrounds, their achievement-the crowning "womb" with a view. The team
"We know C.P.R., we can help!"
LUST BOAT
MEDS '88
was under the expert guidance of merrymaker Ed Kim and Andy Brockway. Amid the remaining seven scheduled rehearsals after Christmas, Miriam " B." Marm and Ashley "H." Yeats choreographed the Lust Boat theme dance and then rehearsed the supporting cast, the Fibrocyte Dancers. Bob Turliuk and Steve Yates alias Captain Sterile Tubing, produced the slide show of pre-natal development after consultation with Dr. Lulu.
Celebrity professors go Hollywood!
"I heard that the scruise director has a case of herpes-not-sosimplex!"
The Lust Boat sailed through smooth waters all week long but encountered heavy waters on Thursday evening-our small blunders made the audience laugh even more. With slightly more than half of the class involved, the Lust Boat docked Friday night, perhaps not as maidenly as before, but with the satisfaction of having thoroughly pleasured Tachyardia audiences.
"... One-eyed trouser snake!"
KISS MY ASS ...GOODBYE. by John MacFadyen, Meds '87 The Meds '87 production of My Gun is Hard began on an upnote, as 45 people turned up at the tryouts. Merrymakers Dave Eden and Terry McAllister had a difficult task to make decisions with the amount of artistic talent that was presented before them. Fortunately, they lowered their expectations and were able to assemble a cast. Rehearsals began right away as we tried to get as much accomplished as possible before the Christmas Exam hysteria set in. Although hindered by an unexpected epidemic of cerebellar ataxia, Sharon " Twinkle Toes" Field took a ragged group of 50 spastic hemiplegics and turned them into a polished chorus line of 50 spastic hemiplegics. At the same time, other members of the class (Rob Hammond, Dave路 Rose, Rudy Zimmer and many others) were putting together a
"And now we're top of the heap, 'A' number one ... "
MY GUN IS HARD
MEDS
'87
"Talk... or I'll inject you with 5 cc's of varnish!"
"Cyanide?!! Oh no my dear, these are in case you fall into friendly hands!"
music video, Clerking With Myself. A residency in Nuclear Medicine has never looked so good. Dr. Whitby came forward with a stunning performance, as a microbiologist in search of his own organism. Before we realized it, it was showtime. In total, over 70 per cent of the class was involved in the production. Outstanding performances were turned in by " Buster" McCauley on the Orgasmatron, " Moriarty" Lawrence on the hypodermic, " Cherry" Wills and her cyanide pills, and " Kitty" Myers on balloons. David Miller did some outstanding production work in coming up with birth control pills, and 25 pairs of black fish-net stockings. We didn't ask any questions! Special thanks to every member of the chorus line for your dedication and hard work. There is a certain New York composer to which we are indebted to as well.
"So, who really cares why pubic hairs are curly?"
"Nurse, leave the operating room, you're not STERILE!"
8-43 IS LIKE A BROTHER TOME by Naoki Chiba Meds'86
SCUT BUSTERS MEDS'88
We were all wrapped up in clerkship, when in Nov. it suddenly dawned on us that Tachy would be soon approaching. In a panic, the Merrymakers hit the phones trying to get our classmates to come up with a theme. This proved to be almost impossible as everyone seemed to be either on call or out of town. At every meeting we would get a different group of 5- 10 people coming out. We finally decided on " Scutbusters" and the scriptwriting was beginning. At each meeting, the script would change drastically, and it wasn't until midJanuary that a very rought draft of the script was done. It still needed a concrete ending! It was only 2 weeks before T achy and we still had no costumes, no backdrops, no songs, no ending, and worst of all...no major rolls filled! Panic was setting in again. Suddenly,
"Suction, coming up!"
"Who you gonna call, Charlie?"
miraculously, people started coming out. Since many of these new people were unfamiliar with the script, it was rewritten, AGAIN! In spite of all the hard work, we did manage to steal a few moments of fun. We did have a great time dressing atrociously and running around U.H. taking picks for our slide show. The dress rehearsal was our first run through of the play without scripts! Anyone who saw us on Saturday could have politely said that we needed some more work on the play. " Miracle" Sunday was a critical day when we rewrote the ending, reworked the dance routines and simplified our lighting and stage directions. Over the course ofTachy Week, our play steadily improved like a fme wine to the point where we almost knew what we were doing. There were a lot of tense, frustrating moments for the 25 or 50 of us trying to put the show together. The Merrymakers would like to thank everyone who spared what little time they had to contribute to our play. No clerkship next year, so beware ofMeds '86!
"This calls for some revival healing!"
BYE, BYE ... FROM MEDS '85 by Doug McKim Meds '85 For their last and least frivolous effort, the Meds '85 gang put all their notorious talents together in the nurturing and grooming of that evil epic, Throbbin Hood. Instrumental in the inspiration and execution of this family favorite were the Menymakers, Mark McLean and Michelle Fretz. Though many plots were considered, this was obviously the most timely, reflecting the current frenzy of activity in the In Vitro Fertilization Clinics. It may also be the Medical students' age old preoccupation with reproduction and its prevention. The plot begins as Throbbin Hood discovers a fiendish plot to rob the village women of their fertility with the perpetrators being none other than Prince and the Sheriff of Knob In Hand. The Prince has been selling
"It's SPADE MARION, is she sobbin about Throbbin?"
THROBBIN HOOD
"Better dysparunia than no parunia at all!"
MEDS '85
.
~
~4
"Go ahead cupid, make my day!"
babies like crazy to the barren women of the village from his Surrogate Mother Clinic. In hilarious Benny Hill style, a film painstakingly filmed and crafted by Joe N egyesi depicts Throbbin and his Meny Men (Scarlet covering the rear!) pillaging Sherwood Forest Mall to get to the gates of Storybook Gardens Castle, home of Prince. In overpowering the guards, Throbbin is able to extract eggs from fertile females of the court during his raid of the Royal Wombery, and to try to reinsert them into the barren village women. AU done with the help of the Laparrowscope! This was our last chance to entertain you on the Tachy Stage. Many thanks to Shelly Metcalfe for tinkling the ivories, and to Susanne McKim for organizing costumes. Special thanks to the unsung heroes behind the stage: Doug MacMillan and Hugh Rooney on sound, and Paul Marek, Rich Schwarz and Bob Chizen on lights. Thanks to All, for four fun years on the stage.
"Don't waste paper, sir... allow me, ahhhh!"
HEALTH, HUMOUR AND HEARSAY by Lila Georgevicb Meds '88 The Ontario Medical Student Weekend was hosted this year by Queen's University from February 8 to 10 in Kingston. The event drew medical students from the five Ontario universities as well as the University of Manitoba and the universite de Sherbrooke. The programme for the weekend presented a nice mixture of academic, social, and recreational activities. The keynote speaker, Friday night, was Dr. Martin Shapiro, assistant professor of medicine at UCLA and the author of" Getting Doctored" an " expose" of the process of medical education. He presented several criticisms of medical education, most notably authoritarianism. He said the fear of failure is strongly ingrained in medical students as a way of molding them to function in a rigidly hierarchical bureaucracy. He also criticized the health care system in general saying that doctors preferred to order expensive, sometimes non-productive tests rather than spend extra time talking to patients to elicit information, which yielded much less financially. Doctors who extra billed, he said, were " parasites" to their health care system and probably prevented some people
from seeking care. His sincerity was questionable to some students considering he had been born in Western Canada, educated at McGill, and then moved to California. There was a shocked silence in the question and answer period when a student asked Shapiro what his annual income was. Without faltering Shapiro answered, " $70,000." A short report on his talk can be found in the London Free Press of February 11 . Wine and cheese were served after the speech and the evening ended early in the morning after a party at Medical House. On Saturday morning, Dr. James McSherry spoke about his unusual hobby- diagnosis of the afflictions of famous people based on their known medical history. He gave interesting presentations on " sweatyng" sickness of the middle ages (which was most likely a form of encephalitis), Mary, Queen of Scots (who probably suffered from anorexia and bulemia), and Sir John A. MacDonald's wife(whowas an invalid for a large part of her life, probably because of psychosomatic illness). Fallowing this bit of " medical hindsight", was Dr. Robert Reid of Queen's Obstetric and Gynaecological department speaking about ' Pre-Menstrual Syndrome: Current Concepts and Controver-
Challis & Nisker, the two forgotten Supremes!
ONTARIO MEDICAL STUDENT WEEKEND '85
sies." He presented experimental evidence that suggests the syndrome is a result of addictive reactions to endorphins produced in the pre-menstrual phase. The symptoms end abruptly with the onset of menses or shortly after, when endorphin concentrations drop drastically. He estimated that as many as 30% of women suffer severe, debilitating symptoms and that 50% of all women suffer at least mildly. Dr. Stylianos Antonarakis, pediatric geneticist at Johns Hopkins School of Medicine in Baltimore, gave a synopsis of current molecular genetics. He touched on restriction length polymorphic fragments , their use in diagnosis, gene mutations and expression, karyotypes, amniocentesis, and the newest pre-natal diagnostic tool, chorionic villus sampling. After lunch, the tone of the programme was lightened by a talk on the " Diagnostic and Therapeutic Uses of Laughter and the Use of Humour in Medicine", given by Dr. Raymond Moody of the Central State Hospital in Georgia. Dr. Moody is the author of ' Laugh After Laugh: The Healing Power of Play". He illustrated how humour is perceived differently by schizophrenics and affective disorder patients, versus mentally sound people. As an example of laughter's therapeutic uses, he
cited the case ofNorman Cousins, aU.S. doctor who " laughed" himself to recovery from a collagen disease by watching old Marx brothers movies. Moody later held a workshop on the use of humour in medicine. The remainder of Saturday afternoon spent at seminars of the students' choice. They chose from among such topics as " The Ethics of In-Vitro Fertilization", Ethical Issues in the Care of the Elderly", " Health Care in Developing Countries", " Holistic Health Care: Revolution or Evolution?", and " Computer Applications in Medicine." The seminars provided a chance for student discussion and the first real opportunity for meeting students from other universities. Saturday ended pleasantly, with a dinner and dance at the Ambassador Hotel in Kingston. On Sunday there were sports and a tour ofKinston arranged for anyone who could mobilize themself after the previous nights party. The weekend was very rewarding and well worth the $25 registration fee. It is Western's tum to host the weekend next year. Arrangements will be underway soon towards creating an interesting and enjoyable weekend that can compete with the weekend hosted by Queen's.
Tacby Band plays Birdland.
IN VITRO FERTILIZATION AT UNIVERSITY HOSPITAL by Gary Redekop Meds '87
Thousands of Canadian couples are infertile as a result of disease or abnormality of the fallopian tubes, endometriosis, or reduced sperm counts. In addition, a significantly large number of couples have been completely investigated without any cause for their infertility identified, yet they continue to be infertile. At least one healthy fallopian tube is essential for natural conception and pregnancy. In many cases where tubal damage has been diagnosed, repair by modem surgical techniques may be possible. In a large number of cases, however, repair is either impossible due to extensive damage, or surgery has already been unsuccessful in restoring fertility . Attempts at fallopian tube transplantation have so far been unsuccessful. Adoption is a possible solution to infertility. However, children for adoption are difficult to obtain, and waiting lists of up to five years are not uncommon. In addition, many couples are not acceptable as adoptive parents because of age or other reasons. The technique of in vitro fertiization and embryo • transfer, therefore, offers an alternative for many couples to become parents. The concept of in vitro fertilization (JVF) is not new. Investigation of the process in animals was carried out as early as 1935, but it was not until July 1978, with the birth of Louise Brown, in England, that the concept became reality. Following the British success, other groups collaborated with the British team. The results of such collaboration have led to the rapid development of IVF technology. There are now many IVF clinics in operation throughout the world, and no significant complications have been reported. Over 700 children have been born as the result of IVF. No increase in the risk of congenital malformations or abnormalities has been demonstrated.
The program at University Hospital began with a pilot study in February 1983 to assess feasability. January 1984 marked the official beginning of the IVF Programme. The project coordinator, Dr. Stan Brown, a graduate of the Western medical program, travelled to Australia to observe the techniques used in an IVF clinic there before the project began. Funding is a major obstacle for
the MRC research group in ReJ>roductive Biology donated lab facilities. Although the laboratory, hospitalization, and operative procedures are covered by OHIP for Ontario residents, the salaries for the non-physician members of the IVF team are not For this reason it is necessary to charge patients an additional fee. The current fee for each cycle of treatment in the IVF program is $1 ,200.00 for
IVF clinics. This type of program is expensive to establish and operate, due to extensive personnel costs. The University Hospital - University of Western Ontario Programme employs a team approach. It includes the participation of the departments of Gynaecology, Nursing, Radiology, Anaesthesia, Social Services, and Psychology . Initially, University Hospital provided funding to start the program, and
Ontario residents. To be eligible for IVF, couples must meet several criteria. Patients entering the program must be 40 years of age or less, have a stable marital relationship, disease of the fallopian tubes or other cause of infertility, and normal male fertility. Patients must be referred by their family physician or gynaecologist. There is no limit on the number of cycles that can be attempted, but patients are
advised to wait at least one month between attempts. Once pregnant, the patient is sent back to the referring doctor. The University Hospital clinic accepts referrals from all parts of Canada and the United States. The program has been very successful in its first year of operation, and workers here are already acting as consultants and advisors to clinics that are just starting. In 1984, the IVF team went through I 34 cycles, and achieved a 25 % pregnancy rate, documented by HCG and ultrasound tests. The ftrst baby was born on December 31, 1984. In addition to technical success, the program is gaining a reputation for being very well organized. Patients are educated about the fundamentals of reproductive biology at Information Sessions, and are kept informed of all that happens during the procedure. The staff works to maintain an atmosphere of support and communication, trying to minimize stress wherever possible. So far the IVF team has had no significant ethical problems. Prior to beginning the pilot project, proposed protocols were submitted to, and approved by, the University Ethics Committee and the University Hospital Board of Directors. The group does no experiments on embryos, returning all embryos to the mother. Some 1VF clinics freeze the socalled ' spare embryos', but this is not practiced here. Any new procedures or experiments must receive further approval. Dr. Brown says that the group "will do nothing without full patient, university, and public awareness." In Vitro Fertilization is no longer at the experimental stage. It is an accepted clinical method, being practiced here in London at University Hospital. As expertise and techniques continue to improve, IVF seems destined to SUJ>plant other methods of treating infertility.
Psychosocial History of the Animal Rights Movement: A lesson in flawed logic R.B. Philip
"Upon this point a page of history is worth a volume of logic." Oliver Wendell Holmes The attitude of the public concerning animal welfare runs the full gamut from a reasonable desire to avoid unnecessary suffering to the stated goal of the extremist element which is, according to Mr. Peter Hamilton (" Life Force", British Columbia) in a recent television interview, the eventual elimination of all animal experiments. Since it is the activities of the latter group which have elicited recent attention in the news media, I shall focus my efforts on this movement. While it consists of many groups with many different names, now, and throughout history, they have been referred to collectively as antivivisectionists. The typical antivivisectionist is white, anglosaxon, Protestant, affluent, urban and frequently female. Lest it be thought that I am displaying a personal bias, I would cite an interview with Holly Jensen, spokesperson for the U.S. Animal Liberation Front, who, in reference to this group, was quoted as saying " We' re mostly women, mostly white, mostly intellectual, mostly upper-middle class" (Toronto Star, Jan. 3, 1985). We are thus dealing with a sociocultural phenomenon having a rather restricted demography. The most vocal and active groups, whose efforts include criminal acts and acts of violence, are centred in Great Britain and in North America. In Central and South America, Africa, India, the Near and Far East, there is no comparable phenomenon. This could be construed as a reflection of the higher priority assigned to more pressing social and economic issues, but that would not apply to such countries as France, Italy, Spain and Eire, where to date, few similar events worthy of international media coverage seem to have occurred. The antivivisectionist movement unquestionably has its historical roots in Victorian England. Prior to the 1860's, most physiological
experiments involving animals were conducted on the Continent, without benefit of anesthetics, since these were not yet widely available. To their credit, most British scientists eschewed such studies, and indeed the earliest recorded call for guidelines to regulate animal experimentation carne not from concerned layment but from Marshall Hall, a distinguished neurologist who, in 1831 set out recommendations for the humane conduct of animal experiments. By 1870, both animal experiments and anesthetics were widely employed in Great Britain and in 1870 the British Association for the Advancement of Science charged one of its committees with formulating guidelines " to reduce to its minimum the suffering entailed by legitimate physiological inquiries". The following year both this body and the British Medical Association adopted a detailed set of guidelines recommending, among other things, the use of anesthetics wherever possible, and the avoidance of unnecessary repetition of experiments. To put this in historical context, only a few years earlier, America had just completed a war to determine the issue of slavery! During the late 1860's, public sentiment against cruelty to animals was gathering. There was much about which to be concerned. Cock-fighting and badgerbaiting were common. Draught animals were blinded (without anesthesia) to work in the mines. Others worked on treadmills to provide power, often with inadequate food and often until they dropped. Of course, children fared no better. At the age often or less, they were put to work in mines, foundries and textile mills and were frequently maimed or killed in industrial accidents. Aroused public concern in the ' sixties led to the formation, under a royal charter from Queen Victoria, of the Royal Society for the Prevention
of Cruelty to Animals (RSPCA), which concerned itself with the plight of abused animals. Antivivisectionist sentiment began to gain strength in the early 'seventies under the direction of a Miss Francis Power Cobbe. Miss Cobbe received much open encouragement from Queen Victoria, herself a devoted animal lover, and from such notables as A !fred Lord Tennyson and Thomas Carlisle, as well as several of the clergy of the Church of England. It is perhaps important to note at this point that the British Monarch is titular head of the Church of England, a role taken rather more seriously in Victoria's day than now. This fact, plus the early participation of the clergy, gave the movement a quasi-religious overtone, echos of which may be heard today in its polernicals against scientists. In 1875 a prestigious group of scientists, including Charles Darwin, Edward Jenner and T.S. Huxley, lent its support to the movement and petitioned the government to enact regulatory legislation. A rift soon developed between the two groups however, owing to the fact that the lay group excoriated all physiologists equally, and declared that animal experiments were useless! This view became dogma to the animal rights movement in the century that followed and it prompted Darwin to publish a rebuttal to the group and its extreme views. In 1876 the Cruelty to Animals Act was passed after six years of deliberations by an august committee which included, among others, the Principal of the Royal Veterinary College, The President of the Royal College of Surgeons and the President of the RSPCA . Canada enacted similar laws two years later. A brief excursion into the social climate of the Victorian era may be instructive. The Victorian English took very seriously their self-assumed role as purveyors of peace, order and good government to those benighted colonies recently acquired. The " white man's burden" included responsibility for the physical and spiritual welfare of the ' less fortunate' races. It was literature that generally treated animals in a
highly sentimental and anthropomorphic manner. In a procession of works that included The Adventures of Alice in Wonderland, Winnie the Pooh, The Owl and the Pussycat, The Wind in the Willows, bears became cute and whimsical, rats and moles slightly stuffy country gentlemen and a toad a bombastic squire. A literary stock-in-trade of the day (even Dickens used it) was to employ abuse of animals as a means of depicting a base and callour character. Conversely the hero, pure of heart and strong of limb, sometimes flogged the drayman with his own whip because of the latter's abuse of his horses. Harmless in themselves, and still charming to read, these stories no doubt deeply influenced a population that was increasingly urbanized and removed from the harsher realities of a rural existence. Together with the open encouragement of the secular and religiou ~ head of the nation and the social, attitudes of the times, they no doubt led some individuals to an extreme and unrealistic view of man's responsibilities toward other species. No similar philosophical position emerged in catholic societies. Roman Catholic dogma held, and still holds, that since animals do not possess an immortal soul, transgressions against them will not be redressed in the afterlife, as will sins against one's fellow man (attributed to Cardinal Sellarmine). This basic philosophical difference is confirmed by an examination of the countries that enacted national legislation regulating the treatment of animals, including those used in science. In 1911 , Great Britain introduced regulations requiring the licensing of persons conducting animal experiments and the conditions under which such experiments could be performed. Similar laws were passed in Germany, Holland, Belgium, Sweden and Norway between 1934 and 1945. Significantly, Protestantism is the dominant form of religion in all but one of these countries. Although Belgium is predominantly Catholic, at the time the legislation was passed ( 1945), political power rested with the Protestant minority.
As an argument against animal experiments, antivivisectionists often claim that it desensitizes the experimenter to suffering and that this may contribute to a more callous attitude toward the suffering of one's fellow human beings. It is one of the great ironies of this debate that the first country after Great Britain to enact rigorous laws regulating the use of animals in science was Nazi Germany. Scientists were required to be licensed, to maintain records, to use anesthetics, to use only the minimum number of animals necessary, and to avoid their use for teaching. This was signed into law in 1934 by AdolfHitler, himself a noted dog lover. Today's cadre of animal rights extremists is extremely small, highly vocal, and more prone to adopt terrorist tactics. In the interview noted above, with Holly J ensen of the Animal Liberation Front (AFL), she stated that the American group numbers about one hundred It is interesting to compare this figure with that cited in a more recent interview with an anonymous member of the Canadian group who indicates that twelve individuals were involved in the recent break-ins at Western (Kingston Whig-Standard). On a population basis, this would suggest that the figure of twelve probably represents the entire Canadian membership of the ALF. Jensen also claims that the ALF traces its origins back to the
" Band of Mercy'', a nineteenth century English antivivisectionist group (further evidence of the " Victorian connection" ). Recent demonstrations of the local group "Ark 11" have seldom numbered more than fifty demonstrators, including young children brought by their parents. What do these people want? According to Russel Francis, identified as the London coordinator for "Life Force", the group which has brought charges against two Western scientists, the movement envisages " a conceptual revolution in which animals will no longer be seen solely as research tools, entertainment devices, or sources of unhealthy food stuffs or unneeded clothing". (Western News, Jan. 18, 1985.) Thus activities are not directed solely at the use of animals in research. These people wish to re-order society entirely according to their own views. The livestock industry would, in their vision of utopia, disappear, along with related supply industries. Since cereal grains and legumes would presumably provide the sole source of dietary protein, pressure on these foodstuffs would increase, to the detriment of third world nations that depend more heavily on them than do we. It will be argued, of course, that cereals presently fed to animals will be diverted directly to human consumption, but this ignores the fact that the principal advantage of
ruminant animals is their ability to convert roughage into protein and much of the range land used for cattle and sheep is unsuitable for cultivated crops. The movement does not appear to concern itself unduly with the economic upheaval and personal hardships that their policy would inflict. This is borne out by the statements attributed to the anonymous member of the Canadian ALF, who indicates that agricultural targets will be the focus of future attacks. Indeed, such attacks already have occurred in Ontario (Kingston Whig-Standard, Jan. 19, 1985). Recently a number of philosophers have entered the debate over the use of an.imals in research. Applying Aristotle's law of logic that, to be valid, an argument must be " true in every instance of its subject'', they reason that experimentation on animals is not justifiable on the grounds that animals cannot reason nor anticipate future discomfort because this argument could be applied equally to young human infants and severely retarded adults. These moral contortionists conveniently ignore the capacity of the infant to become a reasoning being able, perhaps, to compose a great symphony or paint a masterpiece. they ignore also the fact that mental retardation is not an ali-or-nothing situation but a spectrum of degrees of severity. How severe need it be to justify experiments and who makes the decision? Aristotle himself would have recognized immediately the flaw in their reasoning. He said " We must not fail to observe that we often fall into error because our conclusion is not in fact primarily and commensurately universal in the sense in which we think we prove it so. We make this mistake ....when the subject which the demonstrator takes as a whole is really only a part of a larger whole; for then the demonstration will be true of the individual instances within the part and wiU hold in every instance of it, yet the demonstration will not be true of this subject primarily and commensurately and universally." A mouse is a mouse, and a human being is a human being, retarded or not. It has also been argued that man's position at the intellectual pinnacle of the animal kingdom does not entitle him to exploit the other species; that his capacity for moral thought obligates him to
extend that morality to other species. There is nothing inherently wrong with this philosophy. Indeed, it remains a guiding principle for all responsible scientists. The problem is one of priorities. If, as held by the antivivisectionists, it is immoral to employ animals in research, then according to the " true in every instance" law, it is equally immoral for the lnnuit to hunt the caribou, no matter his need When I was a child (some years ago admittedly, but not yet ancient history) every public school of any size had its complement of stock characters. There was the child who had to walk with crutches because of a crippling bout with polio; the child who stayed in the classroom and read during recess because rheumatic fever and a weak heart would not permit boisterous exercise; there was the one who disappeared into a sanitarium for six months to be treated for tuberculosis; the child with the deformed limb or hair lip; the girl whose hair fell out when she contracted scarlet fever and the one who was quiet and withdrawn because her baby brother had died recently from diphtheria. There was the little boy who nearly died from peritonitis following a ruptured appendix and who still had an abdominal drain in place when he carne back to classes. In my school, I was that little boy. Would anyone now under twenty know what an iron lung is? We all did, because we all knew of someone who would spend the rest of their life in one. Every one expected to contract with German and red measles as a matter of course. Where are these children now? Immunization programmes have made history of smallpox, polio, diphtheria and possibly red measles in the near future. Antibiotics have made rheumatic fever and scarlet fever medical rarities, and tuberculosis sanitaria have all but disappeared Marvelous surgical procedures can now straighten limbs and correct disfigurements. My own daughter had corrective surgery of both limbs at the age of three, and is now a beautiful, straight-limbed young lady, instead of being consigned to crutches, or possibly a wheel-chair. None of these advances could have occurred without animal experimentation, not one. Has the price been too high? Ask yourself that question the next time you pass a playground full of healthy, happy children.
IS THERE A DIFFERENCE ?
An Interview with Dr. Jeannette Me G/one
Dr. Jeannette McGlone, a graduate of UWO, is a Psychologist at University Hospital with an adjunct appointment as Associate Professor of Psychology at Westem and an Honorary Lectureship in the Dept of Clinical Neurological Sciences. Journal: How did you become interested in sexual differentiation of the brain? McGlone: I was working as aresearch assistant for Dr. Doreen Kimura, who is a Psychology Professor at UWO. In 1969, her work focused in on the brain, specifically the functions of left and right side of the brain, but she also felt that sex was an important factor. I felt, as well, that this would be an important variable to study, although no one had paid much attention to it with respect to how the brain was organized. I was influenced in part by her work and in part by the volumes of literature in Psychology looking at individual differences in abilities. You are probably aware of the fact that when boys are given spatial tasks that involve constructing things or analysing the environment, they do a better job on average than girls (and that men do better on average than women). Conversely, there is a sex difference in some verbal skills like fluency or grammatical correctness; clerical skills, for example, where females do better than males. There had been some literature supporting sex differences in abilities and earlier work suggested that there might be sex differences in brain and brain organization. So putting these two ideas together, I felt that it was an interesting topic. Many people who study sex differences in behaviour or in the brain have a strong political orientation and they openly admit their bias. I've never felt that that was my motivation for studying it. Journal: How did the hypothesis of sexual differences between male and female brains get started historically? McCione: About a hundred years ago this was a very popular topic to neuroanatomists. It was a political issue at that time. The medical profession didn't believe in the high school education of women and felt that there was biological basis for that opinion. Because the female brain was smaller, they didn't believe she had the intellectual
capacity to handle the learning that went on at high school or the stresses that went on in higher education. There were other ideas such as that females had larger or smaller frontal lobes or larger or smaller occipital lobes; it varied a bit. There was one man, Sir James Chrichton-Browne, who had several publications in the 1880's, who was looking for sex differences in neuroanatomy and the structure of the brain, the frontal lobes, left vs. right, and he did fmd some sex differences. However, all of his results are a bit suspect because the patients died in insane asylums. In the 1960's, a psychologist, Herbert Landsdell, was working in an epilepsy unit in Bethesda, Maryland, giving psychological tests of perception and intelligence to patients who had had temporal lobectomies because of intractable seizures. When he looked at his results separately for the men and the women, he noted a slight discrepancy. I think he was the first one in print to say that the psychological results really depended on which sex he was reporting. He found that after the left temporal lobectomies it was only the males who showed relatively poor verbal skills, whereas after the right temporal lobectomies, I believe, he found again only the males showed relatively poor spatial and perceptual skills. He didn' t find that striking a pattern in the females that he tested. He was ignored by his colleagues (I'm not sure why), but there wasn' t a series of studies trying to replicate him or trying to discredit him. It was a non-issue. Journal: When did sex differences in human brains become a big issue? McGlone: I began to research the topic in 1977, when I was working as a research assistant with Dr. Andrew Kerterz at St. Joseph's Hospital. He allowed me to go through his files retrospectively. He had collected information on patients who had suffered strokes that affected the left or right side of their brains and on whom he had previously administered some tests of language or spatial skills. I thought it would be interesting to look at the effects of similar strokes to see if the psychological effects were the same in men and women. I subsequently published an article, stating that I thought the spatial deficits were more severe in
the men with right hemisphere lesions than in the women. I thought that this indicated that the rights hemisphere might be more specialized for spatial abilities in men than in women. When that article was published, it created a bit of controversy. Then I began my thesis, a prospective study, selecting patients with strictly unilateral lesions, tumours or strokes. My results were published in 1977-78 and these, coupled with my early work, started to get other neuroscientists interested in the topic. Journal: What explanation can be given for the apparent asymmetry in the organization of men's brains? McGlone: The results of my prospective study suggested there were sex differences in the way the brain is organized. For example, of those patients with left brain lesions, there was a greater percentage of men than women with speech disorders called aphasia (proportionately 3x as many men than women). That was the first major finding. The second major fmding was that once you have taken out the aphasics and give them other tests of verbal intelligence, it was the men with left lesions who showed significant deficits of verbal IQ relative to men with right hemisphere lesions and relative to a control group. With the women, we found that the verbal IQ was in the normal range, with left or right brain lesions. Both scored more poorly than control groups, indicating that verbal skills might be more bilaterally organized in the brains of females compared to males. Journal: Could this be due to a different developmental process of organization for male and female brains in utero or do you think that these differences are environmental? McGlone: No-one can know for sure. We can only guess at it. Contrary to earlier theories by Lenenberg that speech develops over time, there is evidence that speech is definitely lateralized in the left hemisphere well before birth. Journal: Are there any sexual differences in the anterior/posterior organization of the brain? McGlone: Dr. Doreen Kimura further subdivided her patients into those with anterior and posterior lesions and found an unexpected sex difference. The incidence of aphasia after left anterior lesions
was the same as for posterior lesions, in the male group. The anterior and posterior areas correspond roughly to Broca's and Wernicke's classical speech areas respectively. However, in the women with left sided lesions, there was a significant difference in the incidence of aphasia. Most female aphasics had anterior lesions; there were proportionately very few women with posterior lesions who were aphasic. Her conclusion was the there is an important intrahemispheric sex difference in the organization of speech. The anterior left hemisphere was much more important for women in speech control, while men had two speech control centres, anterior and posterior. So far it seems that the control over basic executive speech skills is located in the left hemisphere in both men and women, but the control over more complex language functions as measured by verbal IQ might be more bilaterally organized in women. Journal: Are there any clinical applications of your research into sex differences in the brain or is it just a matter of academic curiosity? McGlone: I think it has the potential to matter quite a bit. In the clinical area per se, that is, in people with strokes or other types of brain damage, my research suggests that recovery of function may be different in men and women. If there's more diffuse representation of certain abilities in one sex compared to the other, then recovery should proceed faster and be more complete in the individual with more bilateral or diffuse representation. This may help the clinician select which patient requires cognitive retraining therapy. Journal: Can you explain cognitive retraining therapy in more detail? McGlone: This is a new area of interest for neuropsychologists. We previously felt that there was little point in attempting to retrain patients with memory deficit due to brain damage. More recently with the use of computers and behavioural techniques, we' ve been able to show, at least in the laboratory, there can be improvements in, for example, memory skills or spatial neglect, through therapeutic intervention. Katherine Elsworthy Meds 87
J·W· CRANE: &>lL OF TI-tE MEDICAL SCHOOL
dents anived the next day, he would throw the test in the basket saying, " Since you have all studied for this test, the work has been done and no more good is to by T.E. Feasby be derived from writing it out " A vibrant Medical School, like a How would that be received in 1985? human being, may seem to have a " soul", although this is usually Dr. Crane was a great friend of 'difficult to define.' The search for students and excelled on the such an elusive entity would be human side of University life. He challenging in today's Medical was an informal confidant, adviSchool, but there was once a time sor and loan officer. Many an when its soul was clearly personiimpecunious student received his fied in Dr. James Wellington assistance. Help was often given in the difficult process of securing Crane. Unbeknownst to most, many of the traditions of both internship positions. U.W.O. and the Medical School Many of Dr. Crane's initiatives were initiated and nurtured by this developed into enduring traditions. remarkable man. One of these, Tachycardia, was Born in 1877 and medically born when Dr. Crane started educated in Toronto, he joined the weekly noon-hour sing-songs for faculty of " Western University'' medical and nursing students in Medical School in 1913 as one of 1927. The name " Meds Merryits four professors, a post he held makers" was first attached to the for 24 years. Although he taught . student organizers of the singpharmacology, he was not scientisongs in 1930-31 and an orchesfically trained and he said " I was tra was started which sometimes offered the choice of pharmaplayed at the noon hour sessions. cology or physiology and I was After a lapse during World War mighty weak in physiology." II, the Meds Merrymakers were Fortunately for Dr. Crane, pharrevived and put on their first macology was scientifically unpublic show in the Grant Theatre developed as well, and he was in 194 7. This became an annual able to bring a healthy skepticism production in 1955 under the to his field He believed that name Tachycardia " there was only 1012 drugs of In 1920, Dr. Crane, with a small value and that if the rest were group of students and faculty, thrown into the sea, it would be all started the London Medical Histhe worse for the fishes and all the • tory Club. This endured until Dr. better for man. " Crane retired from teaching in He was not an outstanding lec1934. This club was revived in turer, but he brought enthusiasm 1982 and is currently thriving. and an off-beat approach to his Another medical student historijob. Lecture time was often devocal club, the Osler Society was ted to the great figures of medical started by Dr. Crane in 192 7. Dr. history not pharmacology. He Crane obtained permission from summed up what he wanted from Lady Osler in Oxford to use Sir students in four words: work, William's name. This group was observe, think, record. A peculiar initially an honour society with question on one of his exams top students from each class as emphasized the second of these members but later the memberprinciples: " How many steps are ship was unrestricted Evening there leading to the front door of meetings were held in the home of the medical school?" To get stuDr. Crane on Hellmuth Street, in dents to think, he would occathe homes of members or faculty, sionally give them a frog and some in the City Hall or in a hospital. digitalis and tell them to study the Papers on medical history were drug and draw conclusions. He read by members and many are urged students to record the espreserved today in the library. A sence of articles they read on yearly highlight was the Osler 3" x5 " " epitome" cards. At times, Banquet held in a downtown hoteL he would announce an exam with when the honorary president one day's notice. When the stuwould deliver the Osler Oration.
The oration was sometimes dt}livered by a special guest such as Norman Gwyn, Osler's nephew, in 1930, and Wilder Penfield, a friend and admirer of Osler, in 1942. Dr. Crane remained a constant stimulus for this group long after his retirement In 1959, he made his last tangible contnbution, a then anonymous donation of $1 ,000.00 to help create an 'Osler Corner' in the library. The Osler Society held its last recorded meeting in 1973. Over the years, Dr. Crane started at least lO other medical groups. Included amongst these were the West Elgin Medical Society, the Noon Day Study Club, a lunch time meeting for young London practitioners which met for about 30 years, the Toronto Medical History Club, and the Harvey Club of London, named for the discoverer of the circulation of blood, William Harvey. These latter two groups remain active today. James Crane maintained his interest in U.W.O. medical students long after their graduation. He regularly exchanged Christmas cards with hundreds of graduates. Births of the " next generation of medical students" were recorded. His list of graduates facilitated his organization, in 1927, of the Medical Alumni Association. This led later to the formation of the U.W.O. Alumni Association of which he became director. His tactics for raising money for the Alumni Association are revealed by his circular letters where he referred to MM and MMM. MM stood for magnificent multiple, i.e. instead of sending in a $2.00 alumni fee, one was to shut one's eyes and slip in a $20.00 bill. Adding a third digit made a MMM or multiple magnificent multiple. Dr. Crane was an ardent bibliophile, and like his hero Osler, was fond of giving his books away. The medical library was a regular recipient of his generosity. Today one can easily find books in the library donated by J.W. Crane, some with his distinctive personallydesigned book-plate on which he is pictured at different ages along with Harvey, Osler and a group of U.W.O. graduates against a
background of books, trees (another interest) and University College (Figure 1). In 194 7, he was given an honorary Doctor of Laws degree by W estem The same year, at the annual Hippocratic Society banquet, he was presented with a portrait of himself painted by noted London artist Clare Bice (Figure below). It hangs today in the old common room of the Medical School. Dr. Crane died in 1959 but his legacy survives, continuing to enrich the life of all medical students and faculty at Western. May his " soul" live on and many others emulate his deeds. *This essay is based on a paper read to the London Medical Historical Association, May 1, 1984.
BIBLIOGRAPHY Barr, M.L. A century of Medicine at Westem The University of Western Ontario, London, 1977. Bates, D.G . Dr. James Wellington Crane, Patron Saint of Western. Paper read before the Osler Society, November 20, 1957. Crane. J.W. Diaries and Papers. Archives ofU.W.O. Medical School. Gunton, R W. The Harvey Club of London: A Photographic Essay with Diversions. Presented to the Harvey Club, March 1978. Gwyn. N .B. A short history of the Toronto Medical Historical Club. Canadian Medical Association Journal. 56, 218-220, 1947.
THE VIEWS EXPRESSED WITHIN THIS SECTION ARE NOT NECESSARYILY THOSE OF THE JOURNAL KEITH THOMPSON, MEDS'87 -
ABORTION IS NOT lHE ANSWER Respect for human life is the cornerstone of our society. It is also fundamental to the goal of the medical profession, which is to preserve life by curing disease, by alleviating suffering associated with incurable disease, and most importantly, by preventing disease and suffering. Abortion, the deliberate termination of a human life during gestation, is contrary to the goal of the medical profession and is rarely justified. Many people, both inside and outside the medical profession, try to justify abortion on the presumption that life begins at a specific, but yet undetermined, point in the gestational period and before that point, abortion is not murder. However, attempts to defme this point in gestation when human life begins have been futile since it is well established that human life is a continuum from conception to death involving many stages of development The strongest attempts to justify abortion have been by those who claim that abortion is a woman's right and that its availability is crucial to a woman' s freedom of choice. These people fail to realize that a fetus is not an appendage of
by Jocelyn Charles Meds '87 a woman' s body that she can simply cut out. It is a separate human life dependent on her for nutrition and protection just like a postnatal infant A woman has freedom of choice over her reproductive capacities- it involves responsible use of contraception if she does not want to become pregnant. Once pregnant, a woman has a responsibility to her child and to society to provide protection, nutrition and medical care for her child so that he/ she will have optimal opportunity to develop his/ her full potential. Others try to justify abortion on the grounds that its availability will decrease the incidence of child abuse and criminal abortions. C Iaims that abortion-ondemand will decrease the incidence of child abuse are unfounded. A seven year study at the University of Southern California by Dr. E. Lenowski showed that 90% of 764 abused children were wanted by their parents when they were conceived. It is a striking paradox that one could be concerned about child abuse but support abortion the ultimate child abuse! A rguments that legal abortion-ondemand will decrease the incid-
ence of criminal abortions are also unsubstantiated. A British study, "Illegal Abortions and the Abortion Act of 1967", showed that the incidence of criminal abortions did not decrease after legal abortions became more available. Simlar results were shown in studies in Japan, Hungary, Switzerland, Poland, USSR, and Scandinavia where legal abortions are permitted. Although many support abortion in cases where the mother's life is threatened, or where a defective child, rape or incest is involved, these reasons combined account for only 3% of all abortions. Ninety-seven percent of all abortions, which is approximately 64,000 abortions per year in Canada, are for the sake of convenience or economy. The appeal of poverty is unjustified since contraceptive agents are available free at local health units for those who cannot afford them. The vast majority of abortions are, therefore, performed because women unintentionally, and often carelessly, become pregnant and do not want to be inconvenienced by a pregnancy and the burden of raising a child. Only a very small percent of these unwanted pregnancies represent true contraceptive failures - contraceptive fail-
ures despite responsible and educate1 use of acceptably efficacious methods. This reflects a failure of the medical profession (and others involved in health teaching) to adequately educate women regarding contraception and to take steps to ensure compliance. Simply handing a woman a prescription for birth control pills and telling her to come back in a year for a check-up is just not good enough. It is a responsibility of the medical profession to provide each woman with the education, the means of contraception, and the support and encouragement to ensure compliance so that she may be able to implement her freedom of choice. By not doing this, the medical profession is failing to prevent suffering and loss of life, and therefore it is failing to achieve one of its most important goals. The use of abortion for convenience is a blatant violation of the medical profession' s goals and responsibilities. Therefore, the profession has a duty to itself and to society to condemn such misuse of medical resources and to attempt to correct the cause of this problem by providing women with the education and support needed to competently and ethically exercise their freedom of choice.
HOOT NIGHT
SATURDAY FEBRUARY 9, 1985 Amateur talent night at the Me Keller Room and Medical Students were there!!!!
"Well, I'm a med student an' I got no time for romance" ... DAVE ROSE MEDS '87
ACT 1
DAVE ROSE - Guitar, Vocals
ACT 2
THE PRODIGAL SONSKEITH THOMPSON, MEDS'8 7 - Percussion HOWARD CHIPMAN, MEDS'85 - Guitars, Vocals
JUN 10 '985 CONGRATULATIONS!
PHOTO FROM GAZETTE FILES
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